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Clinical pathways on a mobile device

Clinical pathways on a mobile device
BMJ Evidence-Based Medicine 2020;25:131-137

• This quality improvement project evaluated the potential use of digital clinical pathways in the primary care setting delivered on a mobile platform. Three new-to-practice [USA] primary care nurse practitioners participated in three plan-do-study-act cycles using these pathways installed on mobile devices to determine if they were a feasible, efficient and useful method to implement evidence.  

Abstract

Development of a checklist for people communicating evidence-based information about the effects of healthcare interventions: a mixed methods study

Development of a checklist for people communicating evidence-based information about the effects of healthcare interventions: a mixed methods study.
BMJ Open. 2020 Jul 21;10(7):e036348. doi: 10.1136/bmjopen-2019-036348

• Researchers developed guidance and a checklist to those producing and communicating evidence-based information about the effects of interventions intended to inform decisions about healthcare. The checklist has 10 recommendations. Three recommendations focus on making it easy to quickly determine the relevance of the information and find the key messages. Five recommendations are about helping the reader understand the size of effects and how sure we are about those estimates. Two recommendations are about helping the reader put information about intervention effects in context and understand if and why the information is trustworthy.

Implementation of research evidence in orthopaedics: a tale of three trials

Implementation of research evidence in orthopaedics: a tale of three trials
BMJ Quality & Safety 2020;29:374-381. 20 April 2020

• A time-series analyses to examine the relationship between publication of findings and the implementation (or not) of the findings of three orthopaedic clinical trials funded by the NIHR HTA programme. All three trials favoured the less expensive and less invasive option. In two of the three studies, a change in practice, in line with the evidence that eventually emerged, preceded publication of that evidence.

Abstract

Patient Experience Library

Patient Experience Library

• A Library of over 50,000 documents on patient experience and patient/public involvement.
• Documents include
• Patient experience reports from the local Healthwatch network, and from health and care charities
• Policy and practical guidance on patient and public involvement
• Selected academic and research papers
• National patient surveys from CQC and NHS England
• Quality Accounts from health service providers
• CQC inspection reports
• Valuable archive materials from bodies such as LINk and the NHS Institute
• A subscription service, with some free resources including Insight reports on high level topics and an annual review of latest reports and blog. See the 2018 report here.
• Managed by Glenstall IT

Approaches to better value in the NHS Improving quality and cost

Approaches to better value in the NHS: Improving quality and cost
Kings Fund 4 October 2018

• This report explores how three different organisations (the Royal Free London NHS Foundation Trust, Bolton NHS Foundation Trust and Bradford Teaching Hospitals NHS Foundation Trust) are attempting to improve the value of the services they offer to patients. It examines how they have developed organisation-wide strategies to improve value, and on how individual clinical services or teams have pursued value improvement.
• The report is based on a literature review to assess current approaches to improving value in the delivery of high-quality health care in the United Kingdom and other comparable health care systems. and a roundtable discussion where nine representatives of NHS hospitals and national bodies shared their experiences of value improvement. 
• The organisations’ value improvement strategies and operating context:
• Developing shared clinical pathways across different hospitals. The recent formation of the Royal Free London Group of hospitals has catalysed the development of new clinical pathways that aim to deliver the best possible outcomes for patients at the lowest cost possible. Services are being redesigned across sites through clinical practice groups (CPGs), which bring together medical and finance staff to develop the best models of care across a clinical pathway, such as community-acquired pneumonia.
• Using Lean methodologies and making them more value based. Following a long history of using Lean methodologies at Bolton NHS Foundation Trust, and given the continued financial pressures facing the Royal Bolton Hospital, the hospital has developed a focus on activities to improve the financial position of the organisation/reduce costs, while maintaining the quality of care delivered to patients. The hospital has a central programme management office (PMO) that co-ordinates these activities.
• Codifying and systemising a ‘virtual ward’ approach to cover as wide a range of hospital services as possible. Bradford Teaching Hospitals NHS Foundation Trust has brought together separate ‘virtual ward’ approaches (which allow patients to receive consultant-led care in their own homes) and developed these into its value improvement strategy.

The NHS at 70: What will new technology mean for the NHS and its patients?

The NHS at 70: What will new technology mean for the NHS and its patients?
Health Foundation, the Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust 28 June 2018

• A review of current trends in technology in healthcare and what they might mean for health care over the next 5–10 years if they continue to progress.
• Genomics and precision medicine can target treatment interventions at specific sub-groups of patients, potentially making them more effective and opening up new therapeutic possibilities.
• Remote care can improve access to health care services, enabling patient needs to be addressed as early as possible and potentially making systems more efficient.
• Technology-supported self-management can help to empower patients to better manage and understand their condition, supporting improved behavioural and clinical outcomes.
• Data can provide new ways for the NHS to learn, improve and generate new research – alongside artificial intelligence (AI), which is providing new analytical capacity for diagnosing patients, effective triage and logistics.
• Part of The NHS at 70 - a series of reports requested by the BBC to inform the national conversation about the past, present and future of the NHS.

Report on International Practice on Digital apps: T1 Technology

Report on International Practice on Digital apps: T1 Technology
Digital Health & Care Institute, April 2018

• This landscape review provides an overview and examination of current international initiatives and practices to develop, assess and evaluate the use of mobile health and wellbeing apps and services.
• The examination and comparison of these drew attention to seven cohering quality parameters or criterions, which exist across many of the reviewed initiatives: 
• Privacy / Data protection
• Credible sources / Evidence-based informatio
• Usability / user experience
• Functionality
• Security / authentication
• Effectiveness / Impact
• Interoperability

Evidence-informed health policy

Evidence-informed health policy 

1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence
John N Lavis et al
Implementation Science volume 3, Article number: 53 (2008)

2 – Survey of organizations that support the use of research evidence
John N Lavis et al
Implementation Science volume 3, Article number: 54 (2008)

3 – Interviews with the directors of organizations that support the use of research evidence

John N Lavis et al

Implementation Science volume 3, Article number: 55 (2008) 

4 – Case descriptions of organizations that support the use of research evidence

John N Lavis et al

Implementation Science volume 3, Article number: 56 (2008)